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Transperitoneal versus extraperitoneal approach in laparoscopic radical prostatectomy: A meta-analysis
Kun Wang1, Qianfeng Zhuang, Renfang Xu
1Department of Surgical Urology, the Third Affiliated Hospital of Soochow University, Jiangsu, Changzhou, China.
Medicine
|July 20, 2018
Summary
This meta-analysis found no significant differences between transperitoneal laparoscopic radical prostatectomy (TLRP) and extraperitoneal laparoscopic radical prostatectomy (ELRP) in most key surgical outcomes. However, TLRP was associated with a higher rate of postoperative complications.
Area of Science:
- Urology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Laparoscopic radical prostatectomy (LRP) is a standard treatment for prostate cancer.
- The choice between transperitoneal (TLRP) and extraperitoneal (ELRP) approaches in LRP remains debated.
- Comparative effectiveness data are crucial for surgical decision-making.
Purpose of the Study:
- To compare the transperitoneal and extraperitoneal approaches in laparoscopic radical prostatectomy (LRP).
- To evaluate outcomes including operative time, blood loss, complications, and recovery.
- To provide evidence-based insights for surgical technique selection.
Main Methods:
- A systematic meta-analysis of studies comparing TLRP and ELRP.
- Databases searched include Medline (PubMed), Embase, Ovid, CMB, and Cochrane (January 2000 - January 2017).
- Key outcomes analyzed: operative time, blood loss, transfusion rates, open conversion, intraoperative and postoperative complications, and catheterization time.
Main Results:
- Thirteen studies with 1674 patients were included.
- No significant differences were found between TLRP and ELRP in operative time, blood loss, transfusion rates, intraoperative complications, or open conversion rates.
- A significantly higher rate of postoperative complications was observed in the TLRP group compared to the ELRP group.
Conclusions:
- The transperitoneal approach in LRP shows comparable outcomes to the extraperitoneal approach in terms of operative efficiency and immediate surgical risks.
- The extraperitoneal approach may be associated with a lower risk of postoperative complications.
- Further research may clarify the optimal approach based on specific patient and surgeon factors.
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